Anesthetic apparatus.



0. J. CUNNINGHAM.

ANESTHETIG APPARATUS. APPLICATION FILED JAN. 24, 1913.

1,129,1'W1, E Patented Feb. 23, 1915.

4 SHEETS-SHEET l.

0. J. CUNNINGHAM.

ANESTHETIG APPARATUS.

nmcnxon FILED JAN. 24, 1913.

Patented Feb. 23, 1915.

WITNESSES:

Ofi/O/ J C binning/7am,

By ATTOR/VEK a D. N. m C m H s w m r u w o H P O. C s R s T s P 5 R R o N s m TITE @TATFE PATENT @FFTUE.

ORVAL J'. CUNNINGHAM, OF KANSAS CITY, MISSOURI.

ANESTHETIC APPARATUS.

LIMFJJH.

Application filed January 24, 1913.

To all whom it may concern:

Be it known that I, ORVAL J. CUNNING- HAM, a citizen of the United States, residing at Kansas City, in the county of Jackson and State of Missouri, have invented certain new and useful Improvements in Anesthetic Apparatus, of which the following is a specification.

This invention relates to anesthetic apparatus for administering nitrous oxid and oxygen with the ether sequence.

The apparatus embodying the invention is characterized by the following, and other, advantages: less disagreeable to the patient because of the induction of anesthesia by nitrous oxid and oxygen, rendering the patient unconscious of the irritation from the ether vapor afterward given; quick induction of anesthesia, shortening the time of the most dangerous stage of anesthesia; prevention of cyanosis and clonic spasm, by the use of oxygen; ether vapor is given in a measured dosage by means of a valve provided with a dial and index, permitting a constant, or perfectly graduated, administration; less danger of pneumonia consequent because from 30 to degrees Fahrenheit of refrigeration is obviated by warming the inhalation, no flame nor electricity being employed for the purpose; less danger of aspiration pneumonia and after-sickness, because of the form of dosage producing less oral secretion than by other methods; less danger of overdosage, because the anesthetist has at all times a knowledge of the dosage the patient is receiving; oxygen can be given instantly if at any time the patient begins to show untoward symptoms; economy in the use of ether; thorough mixture of air, gases, or both with the etheric vapor;

nitrous oxid, oxygen, ether vapor and air may be given separately, or in any combination.

The invention comprises, further, a novel mode of and apparatus for, pumping the inhalation to the patient in cases where the usual inhalation method can not be em ployed.

In order that the invention may be fully understood, reference will now be made to the accompanying drawings, in which 2-- Figure 1 is a top view of the apparatus without gas flasks; Fig. 2 is a top view, the top plate being removed and certain parts broken oii' Fig. 3 is a vertical section taken onlineIH-HI of Fig. 1.; Fig. 4 is a ver-' Specification of Letters Patent.

Patented Feb. 23, 1915.

Serial No. 743,986.

tical section taken on line IVIV of Fig. 1; Fig. 5 is a side view of the air and gas valve, detached; Fig. 6 is a side view of the ether valve, detached; Fig. 7 is a bottom plan of the apparatus, the bottom plate bemg removed, the gas arms in section, and holding'the necks of gas flasks in section; Fig. 8 is a longitudinal vertical section taken on line VIIL-VIIT of Fig. 7, omitting said flasks and showing gas-bags connected to the apparatus; Fig. 9 is a horizontal section through the ether chamber, taken on line IXIX of Fig. 4, the valves being omitted; Fig. 10 is adiagrammatic sectional view of my novel pumping attachment.

General description=-l designates a case or housing which contains the ether chamher, the water chamber, the regulating palms, and the various ports and passages. The case is provided with an arm 2 for the attachment of steel flasks containing nitrous oxid under pressure, and with an opposite similar arm 3 for the attachment of flasks containing compressed oxygen. The bottom t of the case has two flanged. openings 5 and (3 to receive coupling necks of gas bags N and O, which are charged from the respective nitrous oxid and oxygen flasks. Plate 1 is also provided with a central boss 7 in which is a threaded socket 8 for the reception of the upper end of a standard (not shown) that supports the whole apparatus at a convenient height. The air intake, A, is in said bottom plate l.

10 is the coupling sleeve to which the in haler tube 12 is connected when a mask is used. In some cases an attachment, such as shown in Fig. 10, is interposed between the inhaler-tube and the sleeve 10.

\Vithin the case 1 are two integral, tapered valve seats 14: and 15 which respectively inclose two plug valves 16 and 17. These valves have the outward form of cone frustums, being tapered to fit their seats and having knobs 18, 19 by which they may be turned. Valve 16 is the ether valve, and valve 1'? regulates the quantities and proportions of air and other gases supplied to form the full mixture.

20 is a horizontal partition forming the bottom of a liquid-ether chamber E. The top of said chamber is formed by a rigid partial diaphragm 21, between which and the top plate 22 are two shallow chambers or passages E" and. H. Diaphragm21 covers the entire area inclosed by the outer walls of the case, except for the valve-seat openings 24, 25, the narrow tapered port 26, and certain other apertures hereinafter mentioned.

W is a water chamber, located immediately below the ether chamber E, and surrounding the walls 27 of a duct I that leads from the ether valve 16 to the coupling 10. Plate 1 is the bottom of the water chamber. Said chamber has an inlet 28 and an outlet 29, which are closed with screw plugs 30 and 31 respectively.

Ether chamber E has an intake 32 and an outlet 33, which are closed with screw plugs 34 and 35 respectively.

Valve-knob 18 is provided with a pointer 36, which plays over a dial provided with a circular rib 3738, the part 37 being higher than part 38 and forming stops for the extreme positions of the valve. Cut in part 38 are a series of notches 39, each of which'is marked with percentage figures as shown. The pointer is resilient and takes into any of said notches. Similarly, valve-knob 19 has a pointer 40, slidable upon a circular rib lhaving terminal notches marked Air and N 0 respectively and a series of intermediate notches 4.2, numbered substantially as shown, one being marked Oxy- Detailed cZescm'pt2'0n.Figs. 7 and 8. The arm 2 is united with the case 1 by a stem 43, in which is a duct 15 connecting with a duct 46 through the arm, and with a small short tube 47 which stops at or near the mouth of bag N. Atthe ends of duct 416 are metal nipples 49, each provided with a rubber washer 50. The ends of arm 2 have integral yokes 51, adapted to receive the necks 52 of flasks (not shown) containing compressed nitrous oxid. These necks have the usual nipple seats and bores 52 and also have conical sockets for the ends of clamping screws 53. Said screws are of sufficient length to have their ends seated in the orifices of nipples 49, so that when only one flask is being used no gas can escape to the atmosphere from the flask in use. The opposite gas arm, 3, is shown as a duplicate in all respects of that just described; the necks 55 being those of oxygen flasks.

From the gas intake 5, a passage 59 leads to a vertical passage 60, which communicates with a small rectangular port 61 in valve-seat 15. From the other gas intake 6, a passage 62 leads to a port 63 in valve-seat 15. A third port 65 is cut through said valveseat, opposite the port 61, and communicates with an air-intake chamber 66, which receives air from atmosphere through opening A.

The lateral walls of the passages 59 and 62, and of chamber 66, are integral with the valve-seats and water-chamber walls, and

stand flush with the bottom plate 4-. One of these walls is a continuous flange 67 extending around and below the valve-seats. The bottoms of the valve-seats are spaced above plate 4 and there is free communication between the interiors of the valves 16, 17 through said space.

The air and gas valve 17 is provided with two ports, 69 and 70, and has a horizontal slit 71 communicating with one side of port 69. Port 69 will register with valve-seat port 63, and port 70 will register with valveseat port 61. When the valves pointer is at Air the air ports 70 and 65 are open, but the gas ports 69 and 63 are closed. By turning the valve clockwise (as seen from above) the gas ports 63, 69 are initially opened just as the air ports 65, 70 begin to close. Further rotation of the valve gradually iiicreases the opening of the gas ports and decreases that of the air ports. After the air is fully cut off, gas port 63 remains open until the valve port 69 passes it. In this position the valve-slit 71 will be in communication with port 63, thereby passing only a minute stream of one gas through said port. The foregoing refers to the gas issuing from the adjacent bag 0, or oxygen. The other gas, supplied from bag N, is first admitted through port 61 after the air port has been closed, and when port 61 is open the other gas port and the air port are closed, excepting that the slit 71 will permit a certain flow through port 63. This valve 17 has no stop to prevent its being turned a full revolution by the operator. Said valve is pressed upward by a spring 72, acting through a collar on a vertical rod 73 whose lower end is slidably mounted in a hole in av bearing piece 7 1 which supports the spring 72 and is secured to an ear 7 5 and extends to a. point below the axis of the other valve 16, where it supports a pressure spring 76 and rod 77 that act on said valve. Thus both valves are held to their seats so that any wear will be automatically taken up and leakage prevented.

Referring now to Fi g. 9: The liquid-ether chamber E is here shown in plan, and its bottom 20 covers virtually the horizontal area of the case except for the valve openings 241-, 25. ether valve 16) are two opposite ports 80 and 81. Around said ports, respectively, are integral walls 82 and 83, which are curved outwardly to provide spaces 81, 85, having bottoms 86, 87. The walls 82, 83 at their tops are integral with the partial diaphragm 21, and said walls shut out the liquid other from the ports 80, 81 one of which is below the surface of the ether in practice. The partial diaphragm 21, which is integral with the case walls 1 and is spaced above the plate 20, is shown in plan in Fig. 2. Besides the aforesaid openings 24, 25, 84, 85, 28

In the valve-seat 11 (ofthe and 32, this plate contains three narrow ports 88, 89 and 90, all located as far as possible from the tapering port 26, and distributed along the side of the case opposite said port. Port .90 communicates with port 26 by way of a passage 91. (Fig. 9). Port 89 communicates with port 26 through a passage 92 (Fig. 9) and port 88 communicates with port 26 through a passage 93. (Fig. 9).

It will be observed that the partial dia phragm 21 is provided with diametrically arranged ribs 94:, which merge into the valve-seat walls and the outer case walls and meet the top plate 22 of the case. These ribs partition oil the ether-vapor chamber E from a similar chamber 11; the former being in connection with recess 85, and the latter with recess 84.

The air, gas or mixture that comes through the valve 17, passes from the bottom of said valve to, and enters at, the bottom of the ether valve 16. Passing through said valve as hereafter described, the gases escape through port 80 and recess 84 into the shallow chamber H, having the outlets 88, 89, 90, through which the gases are drawn into the liquid ether chamber E above the liquid ether therein. Being drawn over the surface of said liquid and becoming etherized thereby, the gases must pass clear across the said surface in order to pass through the taper port 26 into the chamber E", from which the mixture enters recess 85 and passes through port 81 into the ether valve 16. The ribs 9A prevent the gases or air from short-circuiting from chamber H to chamber E" above the diaphra gm. The ether valve 16 is so constructed, however, that all or any pro-portion of the gases employed (whether atmospheric or not) may pass into the inhaler tube pas sage I without passing over the ether. In practice the ether vaporv is sometimes only five per cent. under operating room conditions.

The ether valve seat 14 has besides the ports already mentioned, a third port 96 which opens directly into, the passage I shown in Fig. 3.

In the valve 16 are four ports, 97, 98, 99 and 100. The topmost port, 97, tapers at one end as shown at 97 to an acute end, the

opposite end having the full width of the port. Below said port is a partition 101, which extends downward in a spiral manner to nearly the bottom of the valve. Just below the upper portion of said partition is the second port 98, which has the same shape port 97 but has a different angular position, its acute end 98 being below the widest portion of port 97. Separated from port 98 by the partition 101, is the third port 99, which is similar in form to port 97 and occupies the same angular position thereas. Ports 97 and 99 are in free communica'tion through the interior of the valve, and the partition 101 forms the inner and lower surface of their connecting passage. The lowest port, 100, is similar in shape to the other ports, is opposite to port 99, and is reversely arranged with respect to its taper portion 1.00. This port is cut off from port 99 by the partition 101, but has free communication with port 98, and is on the same side of the valve. Either of ports 99 and 100 is adapted to register with seat port 96, according to the position of the valve. When said valve 16 is in its initial position, ready for use, its port 100 is in full register with seat port 96 to passage 1. At this time, both seat ports 80, 81 are closed, so that the gases by entering the valve will pass directly into said passage 1. When the valve knob is turned clockwise, port 96 is gradually closed, and When it is nearly closed, the ports 80, 81 are initially opened to valve ports 97, 98. As the valve turns clockwise, the ports 80, 81 are farther opened and the percentage of ether thereby in creased. The valves partition 101 cuts off the gas from port 81 but admits it through valve port 98 and seat port 80 into the shallow chamber H from which it passes down into the ether chamber E across same, up into chamber E", thence through seat port 81 into the valve 16, thence through seat port 96 into the passage I. The figures 1 to 15 on the dial of the other valve 17, show percentages of oxygen that may be used with nitrous oXid.

The operation will be as follows: If oxygen or nitrous oxid, or both, are to be used, the proper flasks are attached to one or both of the arms. A suitable quantity of water at a temperature of 90 degrees Fahr. is introduced through the opening 28 of the case. a mask is to be used on the patient, the inhaler tube is connected at 10 and the mask to said tube. If an insu'lilation device, nasal catheter or tube tomouth is used, my attachmentshown in Fig. 10 and presently described, will be employed. The ether pointer 36 is placed at zero, and the airgas pointer 10 is turned to the point marked N 0 and then backward to a figure that corresponds with the percentage of oxygen to be administered. As soon as the patient is anesthetized, the ether valve is gradually turned clockwise until there are indications that the patient is etherized. At that time, the air valve is turned back to the point markec Air in order to replace the nitrous oXid and oxygen withair. It will be evident that by adj usting the two valves, any desired combination of air, nitrous oXid, and oxygen may be administered, and that other alone may be given without disconnecting the gas containers from the apparatus. The gas bags N, 0 receive measured quantities of gas from the flasks when the valves of the latter are opened, and deliver same to the apparatus in the manner hereinbefore described. The water bath, which reduces the usual refrigeration, drops to the temperature of the room, after which it absorbs sufiicient heat from the air of the room to perform its function.

To administer oxygen, unmixed with other gas, the operator simply turns the pointer 40 to the position marked Oxy. This turns valve 17 to such a position that the oxygen inlet 662 is placed in direct communication with passage I, by way of ports 63, 69, through valve 17, into valve 16, through ports 100 and 96. A few breaths of oxygen will completely relieve the occasional laryngeal spasm of incomplete anesthesia without decreasing the amount of ether being used. This effect cannot be produced by air, although the oxygen of the air is usually sufficient if there is no rebreathing. In routine work, I use oxygen only during the administration of nitrous oxid.

Mixed with nitrous oxid, the oxygen is valuable in its effect of minimizing certain disagreeable after-effects.

WVhen about to employ an insufiiation device, a nasal catheter, or a tube to mouth, I disconnect the inhaler tube 12 and attach a valve-case R (Fig. 10) provided with a connection 108 for inhaler tube, a connection 101 for a pump, and a connection 105 for a pressure equalizer. Said valve case comprises three telescopically arranged tubes, 103, 106 and 107. Tube 107 fits within the sleeve coupling 10 and has an exterior bead 108, also at its end a valve seat 109 for a soft rubber disk valve 110, which is mounted on a crosspiece 112 by a screw 111. Between nipples 104 and 105, a second valve 113 is seated upon the outer end of tube 106, being mounted like valve 110. The inhaler tube coupling 11 1 fits the tube 103.

115 indicates a single-acting foot-pump, the piston of which is raised by a spring 116. The pedal 117 is mounted on the piston rod. The port 118 is connected by a tube 119 with nipple 104:.

120 is a rubberbag or other resilient chamber, capable of expansion and contraction, and has its neck fitted into the nipple 105.

During the administration one assistant operatesthe pump 115. By each down stroke of the piston, air is forced past valve 113 into the inhaler tube; valve 110 preventing said air from entering the passage I. By every up stroke of the piston, air and ether or gas and ether are drawn from the case 1 into tube 119 and the pump cylinder, while the equalizer 120 by contracting supplies the patient with the fluid. In practice I have found the operation of this attachment satisfactory. I Having described my invention, I claim as new and desire to secure by Letters Patcut:

1. A case having separate intakes for two gases and air, and a common outlet; means for mixing said gases with air before entering said outlet, means for drawing air or gas and air over liquid ether, and a valve to control the proportions of air and gases.

2. A case having a liquid-ether chamber and an air intake; a partial diaphragm extending horizontally above said chamber, said diaphragm having ports through opposite sides thereof, a valve adapted to admit air through a port at one side and receive etherized air through a port at the other side, and means to prevent mixture of said air and etherized air above said diaphragm.

3. A case having an air intake, an air and ether outlet, and a horizontally disposed liquid-ether chamber; a horizontally extending partial diaphragm spaced between the top of the case and the bottom of said chamber, a full partition across the case between said top and partial diaphragm, a valve seat proximate to said diaphragm and having two ports both communicating with the space above the diaphragm, a valve in said seat, having two ports adapted for respective registration with the valve-seat ports, said diaphragm having ports therein at opposite sides of said partition, a partition in the valve, separating the valve ports, and a passage from one valve port to said outlet.

4. A case, having separate intakes for air and a gas, and a common outlet forboth; two chambered valve-seats in said case, the chambers of said seats being in constant communication with each other, said case having passages from the air and gas intakes to one valve and a passage from the other valve to said outlet; and suitably ported valves in said seats.

5. A case having three separate intakes for air and two gases, and a common outlet for all; two chambered valve-seats in the case, the chambers of said seats being in constant communication with each other, said case having av passage from each gas intake to one valve, a passage from said valve to their intake, and a passage from the other valve to said outlet; and suitably ported valves in said seats.

6. A case having two chambered and ported valve-seats, two valves mounted in said seats and having suitable ports, means permitting air to flow through said valves in succession, and means permitting a gas to flow through said valves in succession and mingle with the air.

7. A case having two chambered and ported valve-seats, two valves mounted in said seats and having suitable ports, an ether-vaporizing chamber having ported communication with one valve, means per-- 'mitting air to flow through said valves in succession, thence through said chamber, thence back to the second valve, and means to permit a gas to follow and mingle with the air.

8. A case having two ported valve-seats, two suitably ported valves mounted in said seats, an ether-vaporizing chamber having ported communication with one valve, means permitting air to flow through said valves in succession, thence through said chamber, thence back to the second valve, and means permitting two difierent gases to follow and mingle with the air.

9. A case, a tubular valve-seat therein having three ports at different heights; a chambered plug valve in said seat, said valve having an air-and-gas intake and four ports, the upper two valve ports being registrable with the adjacent seat-ports, the lower two valve ports being registrable with the lowermost seat port; a duct from the last named port to an inhaler-tube, means for admitting air and gases to said valve intake, and an ether chamber having an inlet and an outlet communicating with the upper two valveseat ports.

10. In combination, a case provided with an outlet for anesthetic, a valve chamber connected to said outlet, two valves in said chamber, each opening in the direction of flow, a single-action pump connected with said chamber between said Valves, and an equalizer connected with said chamber beyond the second valve from the case, and an inhaler tube connected to the valve chamher beyond the last named valve.

11. In an anesthetic apparatus, a casing containing a shallow horizontally disposed liquid-ether chamber, means for continuous induction and eduction of air at opposite sides of said chamber, a water-bath contiguous to said chamber, a regulating valve, an inhalation tube, and a passage partly inclosed by said water-bath and connecting said valve with said tube.

12. In an anesthetic apparatus, a casing, an inhalation tube connected thereto, a valve in said casing, a water-bath within said casing, and a passage extending through said watenbath and connecting said valve with said tube.

In testimony whereof I affix my signature, in the presence of two witnesses.

ORVAL J. CUNNINGHAM.

Witnesses:

F. G. FISCHER, L. J. FISCHER.

Uopies of this patent may be obtained for five cents each, by addressing the Commissioner of Patents,

Washington, D. C. 

